Device for Photoactivation and Reaction Monitoring

Abstract

The present invention relates to a device to photocure and/or photoactivate a photosensitive material. The device comprises several subsystems to transmit light towards an area of interest where a photosensitive material is applied as well as to collect light reflected by the applied photosensitive material. Reflected light is analyzed by an optical detector to monitor the photocuring and/or photoactivation process. Further means to inject or otherwise apply a photosensitive material can be combined in the same device. Methods for applying a fluent polymerizable material to a target site and for effecting polymerization of the fluent light-sensitive material in situ are also disclosed.

Claims

1-19. (canceled)

20. An optical device for at least one of photopolymerizing and activating of a photosensitive material, and for at least one of monitoring and controlling the at least one of photopolymerizing and activating, the optical device comprising: an actinic light source; and an analysis system operatively coupled to the actinic light source, wherein the analysis system is configured to analyze light coming from the photosensitive material to determine a degree of photopolymerization or activation of the photosensitive material during a photoactivation process.

21. The optical device according to claim 20, wherein the analysis system includes: a tubular applicator having a proximal end and a distal end, and an elongated shaft therebetween, the tubular applicator including a light transmitting element configured to bidirectionally transmit light between the proximal end and the distal end, the proximal end being operably connected to the actinic light source, and the distal end of the applicator being configured to emit the actinic light originated from the actinic light source to the photosensitive material and to capture light reflected or emitted by the photosensitive material; and a light guiding element which directs light travelling from the distal end through the light transmitting element towards an optical detector, the optical detector configured to detect the light reflected or emitted by the photosensitive material.

22. The optical device according to claim 21, wherein the light transmitting element includes an optical fiber.

23. The optical device according to claim 21, wherein the light guiding element includes at least one of a beam splitter, band pass filter, and Bragg grating.

24. The optical device according to claim 21, wherein the photosensitive material includes at least one of an implant, a filler, a tissue replacement, and gel or scaffold applied to a living host.

25. The optical device according to claim 21, wherein the actinic light source is configured to emit light in a wavelength range between 200 nm and 3000 nm.

26. A system comprising the optical device according to claim 21 and a device for injecting the photosensitive material.

27. The system according to claim 26, wherein a portion of the device for injecting the photosensitive material is contained within the tubular applicator.

28. The system according to claim 27, wherein the tubular applicator further includes a wall, a lumen, and an interspace between the light transmitting element and an internal side of the wall of the tubular applicator, wherein the interspace is configured to deliver a photocurable fluid material through the distal end of the tubular applicator.

29. The system according to claim 28, wherein the interspace coaxially surrounds the light transmitting element.

30. The system according to claim 28, further comprising: a subsystem to introduce one or more fluids to the interspace between the light transmitting element and the wall of the tubular applicator at or close to the proximal end of the tubular applicator, the one or more fluids forming a photocurable fluid after being mixed.

31. The system according to claim 26, wherein the tubular applicator includes at least one of a needle, a cannula, a catheter, and an endoscopic arm.

32. The system according to claim 26, further comprising: a mechanical element arranged on the tubular applicator, wherein the mechanical element includes at least one of a balloon, a cone-like element, a semi-sphere-like element, and hollow element, that is configured to artificially create a cavity in which a liquid material is pressurized.

33. The system according to claim 32, further comprising: an element configured to press the tubular applicator against a surface in a controlled manner to create a cavity in which the liquid material is pressurized.

34. A method of applying, photocuring, and monitoring a material into or onto a surface or a cavity, the method comprising the steps of: applying an initially entirely fluent, pre-polymeric photocurable material to the surface or the cavity through release from a distal end of an applicator; applying an actinic light from an actinic light source through a light transmitting element to the photocurable material for a time period to convert the entirely fluent, pre-polymeric photocurable material to a polymeric, non-fluent material, the polymeric, non-fluent material being in an amount effective to cover at least a portion of a target surface or a target cavity, the light transmitting element capturing light reflected or emitted by the photocurable material and delivering the reflected or emitted light to a light guiding element that directs light travelling from a distal end of the light guiding element towards an optical detector; detecting by the optical detector the light reflected or emitted by the photocurable material; and monitoring a curing process established by the step of applying the actinic light, including analyzing a change of a property of the light reflected or emitted by the photocurable material and detected by the optical detector, the change being a direct indication of the photocuring process itself.

35. The method according to claim 34, wherein in the step of applying the initially entirely fluent, pre-polymeric photocurable material, the initially entirely fluent, pre-polymeric photocurable material is applied into or onto the surface or the cavity at a certain pressure, in the step of applying the actinic light, directly bonds to the surface or the cavity are established, creating a high adherence between the polymeric, non-fluent material and the surface or the cavity.

36. The method according to claim 35, wherein the surface or the cavity is an animal body tissue or a body cavity.

37. The method according to claim 36, further comprising the step of: introducing the applicator inside the animal body through a surgical device or through an orifice.

38. The method according to claim 34, used for treatment or prevention of a pathological condition or cosmetic procedures such as complete or partial replacement of an organ such as part of the intervertebral disc; replacement, healing or strengthening of cartilage tissues such as the articular cartilage of any joints or non-hyaline cartilage; or injection and hardening of dental cement or hydrogels/composite hydrogels, treatment or filling of an aneurysms, in cosmetic and esthetic surgery procedures such as augmentation mammoplasty or a treatment of glabellar lines.

39. The optical device according to claim 21, wherein the actinic light source is configured to emit light in a wavelength range between 315 nm and 700 nm.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0031] FIG. 1 is a conceptual overview of the device and its subsystems.

[0032] FIG. 2 is a conceptual view of the optical subsystems for illumination and monitoring.

[0033] FIG. 3 illustrates the phenomena underlying the online data analysis, including change in spectra due to photopolymerization and comparison to photorheology data.

[0034] FIG. 4 depicts the combination of injection system and optical light guide in a preferred embodiment allowing for the mixing of two fluid materials and the flow of these materials along an optical fiber. Solid arrows indicate flow of liquid material; dashed arrows indicate light propagation.

[0035] FIG. 5 illustrates the insertion of the tip of the applicator into a cavity or tissue. Fine solid arrows indicate material flow; dashed arrows indicate light propagation, absorption and scattering.

[0036] FIG. 6 illustrates the flow locking system of some embodiments.

[0037] FIG. 7 Illustrates how the injection and photopolymerization method may increase adherence of a photopolymerizable material to a cavity.

[0038] FIG. 8 Illustrates how a cavity is created artificially

DETAILED DESCRIPTION OF THE INVENTION

[0039] The present disclosure may be more readily understood by reference to the following detailed description presented in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this disclosure is not limited to the specific conditions or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed disclosure.

[0040] FIG. 1 is an illustration of two possible embodiments of a device according to the present disclosure. FIG. 1a illustrates a schematic overview of a device comprising at least two functionalities: illumination of a material deposited in a cavity or body tissue 112, and analysis of light that is reflected by or emitted by the illuminated material. To achieve this, the device comprises 3 functional units: an illumination system 103 capable of emitting actinic light, an optical detection and data analysis system 104 suited to analyze light coming from the illuminated material, and a system 105, termed applicator, that allows the targeted application and collection of light to or from a material deposited in a cavity or body tissue. The device consists of at least 2 physical subsystems including a casing 113 comprising a source of actinic light 103 and an optical detection and data analysis system 104; and an applicator 105 that combines the possibility to deliver actinic light to a cavity or body tissue 112 in order to activate or photocure a suitable applied photosensitive or photocurable material and to collect light that is reflected, backscattered or emitted by the material illuminated with actinic light. The light coming from the illuminated material is guided to the optical detection and data analysis system 104 allowing real time monitoring of the photoactivation or photocuring process. The terms “photoactivation” refers to a chemical change a photosensitive material undergoes when illuminated with actinic light, said chemical change providing said material with one or more new functionalities. The terms “photocuring”, “curing”, “photopolymerization”, and the like are herein used interchangeably and refer to the toughening or hardening of a material by cross-linking of polymer chains or to the formation of a new polymer-based material by linking several monomers. Such photocurable materials are polymerized upon exposure to electromagnetic radiation, i.e., light. The light may be microwave, infrared, visible, or ultraviolet light, most typically visible or near ultraviolet. “Actinic light” refers to the kind of light to which a particular photosensitive material is sensitive; in other words, actinic light has the capacity to activate, polymerize or somehow alter the properties of a particular photosensitive material. The term “reflection” or “backscattering” includes specular and diffuse reflection including backscattering. The term “reflected” or “backscattered” refers to radiation reflected by specular or diffuse reflection including backscattering. Specular meaning that the reflected light can have a different wavelength than the illumination light such as for instance for Raman scattering or the emission of fluorescence or phosphorescence.

[0041] The applicator 105 has an elongated shape with a proximal end and a distal end. In the frame of the present disclosure, the word “applicator” refers to any tool or device used to apply an actinic light directly into or onto an area of interest. In at least some aspects, the applicator is a tubular element comprising at least one light-transmitting element such as for instance optical fibers. In one embodiment, the applicator consists of one or more light-transmitting elements which are designed to supply actinic light to the distal end of the applicator and to transmit returning light. In an alternative embodiment of the invention, the applicator has a body, connecting the proximal and distal ends, defining a lumen which contains the light-transmitting elements. The term “distal” refers to a direction toward the end of the device near where the light interacts with the photosensitive material; the term “proximal” refers to the opposite direction, that is, toward the optical detection and data analysis system. The body typically has a length between 0.5 and 500 cm. The body typically has a wall, which is usually made of a biocompatible and resilient metal. The wall is typically constructed from nitinol or stainless steel. In some embodiments, the applicator wall may be a commercially available syringe needle, catheter or a cannula. In yet another embodiment, the applicator may be an endoscope. In some embodiments, the distal end of the applicator may contain a needle. The light-transmitting elements contained in the applicator according to this embodiment of the invention may fill the entire lumen of the body of the applicator, or they may be bound to the wall with adhesive or fasteners or may be touching the wall or may be displaced axially from the wall with spacers, typically made from a resilient polymer. In some particular embodiments, the body of the applicator consists of a catheter or any suitable tubular element having a shape adaptable to the area within which it is inserted, such as for instance a blood vessel. An applicator according to this aspect of the invention may be of various size and shape, typically has a tubular shape, and is constructed of a soft, flexible, biocompatible material.

[0042] The system for illumination 103 of the subsystem 113 may comprise any known light sources capable of producing light with the desired temporal and frequency characteristics. System for illumination 103 may be, for example, solid-state lasers, gas lasers, dye lasers, or semiconductor lasers. System for illumination 103 may also be LED or other broadband sources, provided that the light sources are sufficiently powerful to drive the photocuring process. In some instances, the system for illumination 103 inherently provide short pulses of light at the desired frequency.

[0043] FIG. 1b illustrates a schematic overview of a device comprising at least 3 functionalities: illumination and light analysis as described above, and injection of a photocurable or photoactivatable material into a cavity or body tissue 112. In this case, the applicator 105 has a lumen or one or more channels running throughout the entire length through which a fluid material can flow to the distal end (hereinafter, “tip”) of the applicator. At or near the proximal end of the applicator, fluid materials can be injected via an injection subsystem 102. In combination with the applicator, the injection subsystem is disposed to cause the injected liquid material to flow into and through the applicator leaving it at its distal end where it flows into a cavity 112, onto a surface or to its final location.

[0044] FIG. 2a depicts a preferred embodiment of illumination and data analysis subsystem 113 and a cross-section of the applicator 105. A lightsource 501 with one or several excitation wavelength emits a light beam 100 which is collimated by a lens 502. The lightsource 501 can for instance consist of a laser, a LED and second laser which are combined using a dichroic mirrors. The light beam crosses a wavelength-sensitive beam-splitter 503 and is focused onto light-transmitting elements contained within the applicator 105 by a second lens 504. The so obtained actinic light is guided forward through the light-transmitting element until it exits the device from the applicator's distal end. Once actinic light interacts with a photocurable material, the obtained, back-scattered light is guided from the distal to the proximal end of the applicator where it leaves the light-transmitting element, is collimated by the lens 504 and impinges onto the beam-splitter 503. Photons having a different wavelength or any specific wavelength of interest are reflected by the beam-splitter 503 and focused by a third lens 505 to a monitoring system for data analysis 506, for example a spectral analyzer. Spectral analysis is useful for determining the change of physical and chemical status of the photocurable material. One of the advantages of the system of the present invention is the possibility to monitor the process in real time and therefore tailor the photocuring of the applied material accordingly. During the photopolymerization process brought about by actinic light, an initial low viscosity fluid material will typically have a different spectral signature after its photopolymerization during which its crosslink density or polymerization degree increase. This difference allows to discriminate between a less and a more crosslinked and polymerized material and thus to follow the kinetics of the material property changes, being its viscosity or other physical properties related to the molecular structure of the polymer or illuminated material.

[0045] Due to parallel photorheology measurements, spectral analysis allows to link chemical changes in the material to mechanical parameters thereof, thus avoiding the analysis of the mechanical properties in situ by other means such as indentation. In addition, the spectral signature or the amount of backscattered light also gives information about the position or the environment of the distal tip for instance indicate if a thick tissue segment is blocking the exiting light and thus position of the distal end has to be adjusted.

[0046] In one embodiment, the light-transmitting element consists of several optical fibers. For example, one or several optical fibers 509 can be consecrated to illumination and one or several optical fibers 508 are used to collect the light. In at least some aspects, the optical fibers of the applicator can be arranged in several ways. For instance, fibers transmitting several or certain specific wavelenghts can be envisaged or fibers of different sizes can be assembled to guide the light to the distal end of the applicator and guide it back. In a particular embodiment depicted in FIG. 2b, the light-transmitting element 509 is directly connected to the light source 501 and the spectral analyzer 506 is directly connected to the collection fibers 508.

[0047] In one embodiment, 501 consists of several light sources, of which at least one provides the actinic light to photopolymerize the injected material and at least one provides actinic light at a different wavelength to record the state of the reaction.

[0048] FIG. 3 shows the reflected spectrum recorded over time by a monitoring system for data analysis 506, which in one specific embodiment is a spectrometer. Using the information of the backscattered light, the spectrum gives information on the position or environment of the applicator and indicates whether the applicator is surrounded by tissue or photocurable/photocured polymeric material. Throughout photopolymerization different shifts can be observed: the spectra shifts laterally in function of wavelength or vertically in function of intensity. It is possible that the entire spectra or only one or several peaks shift over time. The change is measured by defining vertical or horizontal axes. Thus a time-intensity plot is created. The change in intensity or wavelength (F) of the spectra or the one of the peaks can be described as using a function f:

F=f(t)

t being the time. By experimental tests a critical value F.sub.c is found. Once this threshold is reached, the user interface emits a signal which indicates that the photopolymerization or chemical reaction has reached a certain degree or is completed. In addition, the information of several peaks or shifts can be evaluated at the same time to increase the precision of the monitoring for instance using reflected light around 750 nm to gather information about the reaction state of material further away from the distal end while using reflected light around 550 nm to access the reaction state closer to the distal end, thus:

F.sub.i=f.sub.i(t)

Or

[0049]
t=f.sub.i.sup.−1(F.sub.i)

i being the indices of one peak. And different functions f.sub.i and thresholds F.sub.c,i can indicate different states of the reaction e.g.:

F.sub.c,1=F.sub.1=f.sub.1(t.sub.1)

F.sub.c,2=F.sub.2=f.sub.2(t.sub.2)

[0050] If F.sub.1 reaches the critical value F.sub.c,1 a signal is emitted, in this case at t.sub.1. If F.sub.2 reaches the critical value F.sub.c,2 a second signal is emitted, in this case at t.sub.2. The procedure is further illustrated in FIG. 3d) and f).

[0051] This evaluation technique is based on fixing F.sub.c,i experimentally. The obtained plot can be subsequently combined with previously performed photorheology measurements. Photorheology measures the elastic modulus (G) of a material in function (g) of the time and total intensity of the light illumination (I):

G=g(t, I)

[0052] Thus, by combining the spectroscopy data (F,f) and the photo rheology data (G,g), the mechanical properties are evaluated online by:

F=f(g.sup.−1(G, I))

or

G=g(f.sup.−1(F),I)

[0053] Furthermore, by testing layers of different thicknesses F can be correlated to an elastic modulus at a certain depth (G.sub.d), thus indicating the state of polymerization at a given distance (d) of the probe:

G.sub.d=g.sub.d(f.sup.−1(F), I)

[0054] The procedure can be further generalized and applied to several peaks (indexed with i):

G.sub.d,i=g.sub.d,i(f.sub.i.sup.−1(F.sub.i), I)

[0055] For example by tacking the changes of peak #1 the elastic modulus at a distance of the tip d0 (which could be for example 5 mm) is deduced:

G.sub.d0,1=g.sub.d0,1(f.sub.1.sup.−1(F.sub.1),I)

[0056] Materials layers of serveal thickness (or at several depth) can be evaluated (FIG. 3f)

[0057] In case of a tissue layer blocking the exiting light the intensity FIG. 3a would suddenly increase (several orders of magnitude are possible) and the spectra would also change in function of wavelength. As certain tissues have a given reflection spectra when illuminated with light such reflections can be used to further give information (e.g. about the type of material in front of the tip—for instance tissue, blood or injected material) to the operator (e.g. surgeon) when performing an operation.

[0058] Finally, several peaks F.sub.1 and F.sub.2 can be compared and a critical value F.sub.C can be calculated for instance by dividing them (F.sub.C=F.sub.1/F.sub.2) or performing any other type of mathematical calculation.

[0059] FIG. 4 is a cut view of the injection subsystem 102 according to one embodiment of the invention. Two mechanisms are responsible for combining the injection and illumination functionalities: there is a type of crossing where a fluid material can be brought close to the light transmitting element 205, along which the fluid material will flow towards the tip of the applicator. In this particular embodiment, the device consists of several injection channels (for the sake of simplicity, only two channels 201 and 202 are depicted in FIG. 4), an outflow channel 203 and a fiber channel 204. The injection channels can be aligned in an arbitrary way. The outflow channel 203 and the fiber channel 204 have to be sufficiently collinearly aligned not to over bend the light transmitting elements 205 which are typically optical fibers. The light transmitting elements 205 are inserted through the fiber channel 204 and leave the injection subsystem 102 through the outflow channel 203. The injected material can flow in both directions in the injection channels (solid arrows). The injection subsystem 102 is either an integrated part of the applicator or a separate entity connected to the applicator via the outflow and fiber channels. In either case the outflow channel 203 is connected to the distal end of the applicator where the photoactivable fluid material is ejected out of the device. In one embodiment, more than one fluid material can be delivered within the applicator through the injection channels 201, 202. These fluid materials are mixed once in the applicator, thus permitting for instance the constitution of a photocurable material starting from two or more non-photocurable materials.

[0060] The various channels of the injection subsystem may be stabilized within a housing that may be made essentially of a solid inert material and may comprise a holder to hold the device ergonomically during its use, such as for instance during surgery procedures. The light delivered by the light transmitting elements 205 is transmitted in both directions (dotted arrow), illuminating the injected material and back-propagating the light reflected or emitted by the illuminated material. Guiding elements 206 permit to align the light transmitting elements in the device while avoiding the block of the fluid flow (for example by not surrounding it completely in the radial plain).

[0061] FIG. 5 shows the mode of action of a particular embodiment of the device according to the present invention. The tip of the applicator is inserted into a tissue cavity 112 surrounded by the remaining tissue 301, such as for instance a bone cavity surrounded by bone. The cavity 112 can be closed as illustrated in FIG. 5a, and can be for instance missing nucleus pulposus of an intervertebral disc, but it can also be a surface or hole such as a bone void to which the distal end of the applicator is brought to. The applicator of the device comprises a body 302 such as a solid or flexible cannula and one or more optical fibers 205 as light-transmitting elements. A fluid, photocurable material (solid arrows) pushed under an external force, flows through the outflow channels 203 which in this embodiment are interspaces between the light-transmitting element and the internal side of the applicator's body wall 302, into the cavity 112. The light (dotted arrow) guided into the optical fibers impinges onto the injected material where it is absorbed or scattered into different directions and then absorbed elsewhere. Some photons are also reflected or back-scattered and back-propagated through the light-transmitting element 205. In one embodiment, the applicator consisting of a cannula and an optical fiber, the tip of the cannula 302 and the tip of the light-transmitting element 205 can be placed at the same height or at a given distance. In one embodiment, the light-transmitting element can be inserted before or during the use of the device, and it can be moved forward (FIG. 5b, solid arrow) or backward and possibly laterally within the applicator during the procedure. In another embodiment in which the applicator comprises a cannula, the tip of the light-transmitting element 205 and the cannula can be flat or sharpened with a given angle 304 (FIG. 5c). In a particular embodiment, this angle can be different for the cannula and the fiber. In one embodiment, the light-transmitting element and the applicator's body can touch each other (305) or move freely (307), and they can have the same or a different curvature (306) (FIG. 5d). The use of other kind of tips for the light guide (e.g. implemented lens, ball lens, diffuser, conical shape, side-fire tip, transparent balloon tip, etc.) can be used.

[0062] In a particular embodiment, the device according to the present disclosure comprises a back-flow locking system, as shown in FIG. 6. At the end of the fiber channel 204 a screw-tap with hole 401 is screwed into the housing of the injection subsystem. The tap has a hole in the middle to insert the light-transmitting element 205 and it can be guided by lateral joints 403. Between the screw-tap and the device a rubber ring 402 is placed. When the screw-tap is screwed into the device the ring starts to act as a valve. It deforms and locks at the same time the space between ring and device (404), ring/screw-tap (405) and ring/optical fiber (406). Thus any backward outflow through the channel 204 is inhibited and the fluid inside the device can be pressurized up to 50 bar.

[0063] FIG. 7 depicts a particular embodiment of the invention in which a fluid, non-polymerized material is directly injected into a body tissue having pores, (micro)cavities and/or voids such as the bone tissue. The tip of the applicator is put within or in close proximity with the porous or hollow tissue structure. This can be achieved through surgical meanings, such as for instance via a pre-formed bone drill wherein the applicator is inserted. The photocurable fluid, non-polymerized material flows through the interspace 203 between the optical fiber elements 205 and the internal side of the wall of the applicator under an applied pressure via e.g. an injecting system or simply a syringe. These syringes may be used to inject the fluid material, but they can also be used for mixing several materials together or increase the pressure to a given level during injection. They can be plugged in or screwed onto the device. They can be fix or removable parts of the device, specifically designed and adapted to the viscosity of the injected materials and the medical method, or they can be commercially available syringes. The pressurization and its viscosity allow the fluid, non-polymerized material to flow into macro- (701) and microscopic (704) pores of the tissue or bone 301. The pressure, preferably between 0 and 50 bar, and the viscosity, preferably between 10.sup.−5 and 1 [Pa s] or also higher, are key elements to increase the adherence of the fluid, non-polymerized material with the surrounding tissue it was injected in. Once injected, or alternatively during injection, the light can initiate the photopolymerization reaction by directly illuminating the pore 702 or also by being transmitted and scattered through the tissue 703, thus permitting the change of physical status of the fluid, non-polymerized material to a non-fluent (or solid), polymerized material. Once a polymerized material is created in the cavity, it physically blocks the macro-pore 701. The same type of entanglement can be created in micro-pores 704 which have a similar size of the polymer chains 705: due to its completely unpolymerized state and the applied pressure, the chains diffuse into the tissue pores and block them (706) once they solidify. Furthermore, covalent bonds (707) or other chemical bonds can be established between tissue and polymer molecules further increasing the adherence. Moreover, if a composite material containing fibers 708 is used (e.g. cellulose fibers) some of the fibers can dangle into macro- or micro-pores and once the polymer matrix around them solidifies also contribute to a higher adherence between injected material and tissue.

[0064] In at least some embodiments, the photocurable material can therefore be a filling material such as a natural or synthetic material for strengthening, replacing, healing, reinforcing or otherwise treating living tissues such us bones. Suitable filling materials include glues, epoxies, adhesives, cements, hard tissue replacement polymers, biodegradable polymers and copolymers, and various other biomaterials known in the art for strengthening, replacing or reinforcing tissue. As inert materials, bone reinforcing mixtures may be incorporated into surrounding tissue or gradually replaced by original tissue. In some embodiments, the photocurable material may be a filling material such as composite hydrogels for strengthening, replacing, healing, reinforcing or otherwise treating a nucleus pulposus of an intervertebral disc such as for example methacrylate and poly(ethylene-glycol) based polymers in combination with a photoinitiator and possibly reinforced with fibers such as cellulose nanofibrils. Those skilled in the art will recognize that numerous variants of the above mentioned materials known in the art are within the scope of the presently disclosed embodiments.

[0065] FIG. 8 A liquid can only be pressurized in a contained space. In some cases such as aneurysms, when treating the surface of a vessel or a specific area such as the surface of a joint or an organ the injected liquid might flow away from the target area. Therefore this target area has to be closed. The simplest solution for this is to press the distal end onto the tissue (FIG. 8a). Contact points 801 (or contact lines) are created and the closed cavity 112 is formed where the liquid 107 can be injected. In this case the lightguide 205 is placed not directly at the distal end but slightly inside which creates a space which can be illuminated. In one embodiment especially when the tissue 301 is a hard surface such as from a tooth, the front end of the cannula consists of a soft material (e.g. rubber or any other biocompatible and soft material) 802 which deforms when pressed against the tissue. In another embodiment (FIG. 8b) the front end of the cannula has a wide opening 803. This structure has a conic, a half-sphere or any other shape adapted to the physiology of the tissue. Such a cone can be a rigid part of the cannula. It is also imaginable that it is opened once the cannula reached its target passion for by means of a mechanical mechanism for instance similar than an umbrella or when opening a stent using a balloon. In at least one embodiment the wall of the cannula consists of a soft and highly deformable material 804 with a gas (e.g. air) or liquid (e.g. water) cavity 805 inside. In FIG. 8c is an example presented where the air or liquid cavity is a ring inside the wall of the cannula which can be filled from outside using for instance a tube to access the cavity. Thus the cannula can be inserted at a minimal diameter and once it is inside its diameter can be increased. This allows to close cavity such as an aneurysm or a blood vessel to create temporarily a closed space with a given pressure. A further example is given in FIG. 8d) where only a part 806 of the otherwise rigid cannula consists of a soft material with a cavity 807 inside. Once it is pressurized the cannula is pushed in a lateral direction against the wall opposite of the tissue cavity or blood vessel.